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血流动力学模型预测的颈动脉弯曲和分叉处动脉粥样硬化的组织学验证。

Histological verification of atherosclerosis due to bends and bifurcations in carotid arteries predicted by hemodynamic model.

作者信息

Singh Rajani, Tubbs Richard Shane

机构信息

All India Institute of Medical Sciences (AIIMS), Department of Anatomy, Rishikesh, Uttrakhand, India.

Seattle Science Foundation, Seattle, WA, USA.

出版信息

J Vasc Bras. 2018 Oct-Dec;17(4):280-289. doi: 10.1590/1677-5449.004118.

DOI:10.1590/1677-5449.004118
PMID:30787945
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6375265/
Abstract

BACKGROUND

Tortuosity and bifurcations in carotid arteries alter the blood flow, causing atherosclerosis.

OBJECTIVES

The aim of the present study is to analyze the effect of variant vascular anatomy in the cervical region on development of atherosclerosis by microanatomical examination.

METHODS

The effect of blood flow at anomalous bends and bifurcations was observed in right carotid arteries of a seventy year old female cadaver. Fifteen histological slides were prepared from the carotid arteries and interpreted to verify predictions of atherosclerosis.

RESULTS

The model predicts atherosclerosis at bends, bifurcations and large aperture arteries. Microanatomical examination revealed presence of atherosclerosis of varying thickness at the bends and bifurcation in the right carotid arteries, as predicted. Atherosclerosis was also detected in the straight part of the wider common carotid artery. No atherosclerosis was observed in the contralateral carotid arteries. The variant carotid vascular anatomy consisting of bends, bifurcations and wider arteries revealed that the shear stress and velocity of blood flow are reduced at these anomalous sites.

CONCLUSIONS

Anatomical anomalies such as bends and branching in the carotid arteries alter the irrigation pattern and generate biomechanical forces that cause turbulent flow and reduce shear stress/blood flow velocity. Decreased shear stress and velocity causes development of atherosclerosis. Histological slides established the presence of atherosclerosis at bends and bifurcations and in wider arteries.

摘要

背景

颈动脉的迂曲和分支会改变血流，导致动脉粥样硬化。

目的

本研究的目的是通过微观解剖学检查分析颈部变异血管解剖结构对动脉粥样硬化发展的影响。

方法

在一名70岁女性尸体的右侧颈动脉中观察异常弯曲和分支处的血流影响。从颈动脉制备了15张组织学切片并进行解读，以验证动脉粥样硬化的预测。

结果

该模型预测在弯曲处、分支处和大口径动脉会出现动脉粥样硬化。微观解剖学检查显示，如预测的那样，右侧颈动脉的弯曲处和分支处存在不同厚度的动脉粥样硬化。在较宽的颈总动脉的直管部分也检测到了动脉粥样硬化。对侧颈动脉未观察到动脉粥样硬化。由弯曲、分支和较宽动脉组成的变异颈动脉血管解剖结构显示，这些异常部位的剪切应力和血流速度降低。

结论

颈动脉的弯曲和分支等解剖异常会改变灌注模式并产生生物力学力，导致湍流并降低剪切应力/血流速度。剪切应力和速度降低会导致动脉粥样硬化的发展。组织学切片证实了弯曲处、分支处和较宽动脉中存在动脉粥样硬化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fde0/6375265/3b9ddf439cb2/jvb-17-04-280-g05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fde0/6375265/7d5fc19c3828/jvb-17-04-280-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fde0/6375265/99b21ad4dba0/jvb-17-04-280-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fde0/6375265/3b9ddf439cb2/jvb-17-04-280-g05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fde0/6375265/7d5fc19c3828/jvb-17-04-280-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fde0/6375265/99b21ad4dba0/jvb-17-04-280-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fde0/6375265/3b9ddf439cb2/jvb-17-04-280-g05.jpg

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